What is CBT for Depression?

We believe that underlying negative thoughts and beliefs about self, the world, and the future cause low mood, a sense of defeat, and loneliness.

We know that it is difficult to directly change our moods, but it is easier to look at the thoughts behind how we are feeling and work on how these thoughts effect how we feel.

With the help of a therapist we can learn to become aware of how our negative thoughts effect our feelings of self-esteem, how we act, and our social relationships. We can test the reality of our thoughts and choose to keep or to change them, in order to feel better.

Once we learn new patterns of thinking we can also learn coping and communication skills, and by becoming more engaged in daily activities pleasure will return.

What are the Stages of CBT Treatment for Depression?

Often when we are feeling down it is difficult to feel motivated to act. We know that if we schedule small activities, even when we don’t feel like it, we soon begin to have pleasure and satisfaction in achievement again. Once we start to feel some accomplishment we can look at our thoughts and the underlying beliefs. We can set some goals for therapy together, and order which issue we would like to work on first. The therapist can explain how modifying perceptions of situations influences how we feel about them and choose to act. Once we begin to rate the pleasure of activities, finding joy in small changes can add to a renewal of energy and daily satisfaction.

Identifying cycles of behavior, and patterns can be done in session to provide the foundation so that stopping our negative thoughts can turn moods around, and role playing can be practiced to correct negative thoughts. Often anxiety will be lessened by learning grounding and mindfulness exercises to slow down the thinking, keep you focused on the present, and decrease the physical sensations of chronic worrying. Learning of the new beliefs, and confronting your the old beliefs can decrease anxiety, irritation, and anger. Planning for relapse, increasing supports, and continued education can be useful steps to learn regulate your emotions, find meaning in relationships, and instill confidence in your communication skills.

Anxiety

Who can we help?

If you experience anxiety you may have difficulty getting your mind to turn off so that you can sleep. You may worry and have stomach upset that effects your appetite and health. You may avoid situations where you feel anxiety which may limit your daily life.

Anxiety is described as an emotional state characterized by tension surrounding impending crisis, danger, or threat. Sometimes you can feel anxiety in your body with tension in your muscles, a pounding heart, and increased breathing rate.

Many with anxiety cannot remember when it began, and say it has been with them all of their lives. Difficulty controlling the worry experience, restlessness, and difficulty concentrating may result in reduced quality of life. You may think of the worst case scenario about future events and even minor events can seem insurmountable. Your mind may go over one topic and get “stuck”, so you end up worrying about a wide range of topics.

Anxiety was once an adaptive response to deal with stress, but in now it can cause a wide range of problems in controlling our physiological responses to challenges and we often need help to take control of our thoughts, minds, and lives.

What is CBT for Anxiety?

Cognitive behavior therapy for anxiety is based on the belief that it’s not stressors that cause anxiety, but how we think about them and what we believe that makes us feel anxious. Identifying the first thought before upsets can be a useful skill to learn to become aware of how negative patterns drain our energy, and trigger our fears. Anxiety can be a bully, and we can learn to face it by looking at the advantages and disadvantages of each thought, as well as testing how realistic our beliefs about the fear are. In a safe and supportive environment, you can begin to explore your fears and slowly imagine being expose to them, until you find you can tolerate and face many other situations that used to cause you concern in your work and home life. Slowly, your tolerance will increase to real life situations, and your world may open up to increase your confidence in your ability to enjoy all life has to offer. Dealing with anxiety with a professional can help you learn ways to cope with stressors yourself, and these skills will transfer into other areas of your life.

Case Study of a Client with Depression and Anxiety

When Bonnie came to therapy she was suffering from depression and anxiety. Over the past few months she had noticed her energy levels going down and her motivation was to the point that she had to force herself to get out of bed every day. She stated that she felt like there was something terribly wrong with her and she suffered from worries that she may eventually not be able to function at all. Her relationships suffered because her family had to do more around the home, and she reported that her self-esteem was at an all-time low because she did not understand what was wrong with her.

Bonnie was brave, and desperate to find help, so she came to us in tears just hoping for someone to talk to in confidence. The first session she commented on what a relief it was to know she could share in a secure space, and know that sharing with a professional does not add strain to her support network, or pile on more worries for her family. We did an assessment that showed she had many symptoms of clinical depression and anxiety, and she said she was relieved to have a name for what was happening to her.

Bonnie enjoyed learning about how depression and anxiety effect people, and she could relate to many of the feelings others share about their symptoms. She felt validated in her concerns and knowing there was physical causes to depression helped normalize her experience and give a name to what she was experiencing.

Bonnie began to schedule small activities she could do to become more active. Within a week she reported feeling a sense of accomplishment from completing small tasks to help out in the home. She began to explain what was happening to her to her family, and they found renewed strength to support her now that they understood her limitations.

Bonnie struggled to become more active, and resume activities because at first she did not feel like doing them, but her therapist reassured her that she must act before she felt like it, in order to change her mood and avoid setbacks in her functioning.

Bonnie began to understand how her underling thoughts and beliefs were affecting her mood and self-esteem. Within a few months her scores on the assessments showed lower levels of anxiety and depression. We begin to focus on some underling irritability and frustration by doing anger assessments and examining her underlying thoughts of feeling put down, that triggered her irritability. Soon she learned to voice her feelings appropriately, her scores on the anger scale decreased to normal levels and she reported that she wanted to decrease the frequency of sessions, and focus on next steps toward getting her life and her independence back.

Anger Management

Who can we help?

Anger is characterized by muscle tension, frustration, and irritability that can be expressed in verbal and physical behaviors. Anger may activate aggression which can cause a host of behaviors and negative consequences. Anger may be exacerbated by feelings of vulnerability, lack of self-esteem, being exploited by others, and deprived of love and protection as a child. Stress may increase the tendency to act impulsively in social situations and when facing confrontation. Beliefs that we have been unjustly treated can lead to hostility and rage, leaving us feeling guilty and alone.

Childhood trauma or emotional abuse can increase our negative feelings of self and low self-esteem is linked to anger management and behavioral issues.

When you are calm, ask your family how your anger affects them. If there is cause for concern call us today, and we can begin to learn ways to manage your irritability. If your relationships are suffering from your angry feelings and behaviors, you can learn to use Cognitive Behaviour Therapy to cope by learning to become more aware of your feelings and perceptions.

CBT for Anger Management

Cognitive behavioral therapy for anger management is based on the idea that negative thoughts associated with feeling unjustly treated often come before the emotionally feeling of uncontrollable anger, and acting out. An assessment of anger can be useful in determining the specific things in the environment that sett you off, and this information will be very helpful in treatment because you can learn to anticipate when you will become upset.

When you are upset you can ask yourself “what just went through my mind”? Recording the thoughts before the angry behaviors occur can increase awareness of the beliefs about other people’s reactions to you and what they mean to your concept of self. We can identify the triggers you have that occur and the physical sensations of a fast beating heart, flushed face, or muscle tension that come just before you lose control. Challenging those first negative thoughts based on your beliefs about what other people are thinking can be a first step in decreasing your irritability. Substituting positive thoughts can help decrease aggravation and increase your sense of competence. Increasing your self-care can help you to increase self-esteem, and let you see yourself and others in a kinder light. Coping skills to deal with social situations and communication training can help you to manage situations before anger takes control. Relaxation techniques can be used to regain control and decrease feelings of threat and fear.

Learning other ways to react can help you to begin to enjoy relationships at home, at work, and in your community. Learning to be kinder to yourself will lead to gentler thoughts of compassion for others, and life without the turmoil of the anger behavior cycle can begin to be appreciated, as a new normal for social relations is established.